Effective control of a complex disease such as breast cancer requires a multidisciplinary approach that bridges the gap between the "why and what" of cancer causation and the "how" to prevent cancer incidence morbidity and mortality. This Preventive Oncology Academic Award will provide the candidate the opportunity to strengthen her skills in clinical trial design and biostatistics, develop her knowledge in molecular biology, pharmacology and toxicology and give her the necessary research experience to successfully integrate a multidisciplinary approach into the design of effective chemoprevention strategies. The candidate will attend courses offered at Johns Hopkins as well as the National Cancer Institute (NCI) focusing on clinical trial design and the use of biomarkers in epidemiological and clinical research. She will participate in conferences, rounds and seminars both in the Department of Epidemiology and in the Oncology Center. She will also engage in a limited amount of teaching and clinical oncology work relevant to her cancer prevention activities. In keeping with the candidates goal to become proficient in the design, conduct and analysis of intervention trials two clinical studies are proposed to examine the efficacy of an aqueous extract of broccoli sprout or "tea" (BST) as a chemopreventive agent for breast cancer. The first study evaluates the pharmacokinetics and pharmacodynamic action of broccoli sprouts tea in 30 healthy women undergoing breast reduction surgery by conducting a two-week dose-finding clinical trial that measures both phase 2 inducer activity and isothiocyanate metabolites in mammary tissue. In the second study, a phase II randomized trial design will be used to test whether a 3 months intervention of BST modulates a panel of specific tissue biomarkers of breast cancer risk compared to placebo, in 126 women at increased risk for breast cancer. Together these planned developmental experiences along with the supportive environment and research infrastructure of Johns Hopkins and the mentorship of Dr Kathy Helzsouer and Dr Nancy Davidson will ensure Dr Visvanathan's successful transition into an independent cancer prevention and control investigator with expertise in chemoprevention trials.